| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
202 |
197 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59 |
58 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
72 |
36 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
30 |
$436.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
16 |
$194.81 |
| 96160 |
|
42 |
42 |
$93.84 |
| 99000 |
|
39 |
38 |
$0.00 |